Provider Demographics
NPI:1811372089
Name:POOJA ASWANI DENTAL CORPORATION
Entity Type:Organization
Organization Name:POOJA ASWANI DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJA
Authorized Official - Middle Name:
Authorized Official - Last Name:ASWANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-869-5527
Mailing Address - Street 1:12923 INGLEWOOD AVE
Mailing Address - Street 2:#3
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5139
Mailing Address - Country:US
Mailing Address - Phone:310-263-1030
Mailing Address - Fax:310-263-1043
Practice Address - Street 1:12923 INGLEWOOD AVE
Practice Address - Street 2:#3
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5139
Practice Address - Country:US
Practice Address - Phone:310-263-1030
Practice Address - Fax:310-263-1043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49282261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental